科研之友
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摘要
Background: Locking-plate osteosynthesis is a well-established treatment option for proximal humerus fractures. The standard approach is delta-pectoral, but few data using the minimally invasive anterolateral delta-split approach exist. %26lt;br%26gt;The aim of the study was to prospectively evaluate shoulder function and radiological outcome after a minimally invasive antero-lateral delta-split approach. %26lt;br%26gt;Materials and methods: From December 2007 to October 2010, 124 patients with proximal humerus fractures were treated with locking-plate osteosynthesis using a minimally invasive antero-lateral delta-split approach. Complete prospective clinical and radiographic data were available for 97 patients for a minimum 1-year follow-up period. %26lt;br%26gt;Results: After a follow-up period of 18 +/- 6 months, the patients achieved a mean absolute Constant score of the injured shoulder of 75 +/- 11, equalling 91% of the contralateral shoulder Constant score (p %26lt; 0.01). %26lt;br%26gt;Implant-related complications (e. g., screw perforation) were observed in seven patients (7.2%), and avascular necrosis occurred in eight patients (8.2%). Damage to the ventral branch of the axillary nerve was recorded in four cases (4%) without any clinical consequences. The mean delay between trauma and surgery was 0.5 days. The procedures were performed by a total of 16 surgeons who required an average of 73 +/- 27 min of OR time and 108 +/- 121 s of fluoroscopy time. %26lt;br%26gt;Conclusions: Minimally invasive osteosynthesis using angle-stable implants for proximal humerus fractures demonstrated good functional results. Compared to the literature, this minimally invasive procedure resulted in a shorter operation time and may have reduced the avascular necrosis rate. Level of evidence: Level IIb, monocentric prospective cohort study.
- 出版日期2013-4
